Your task is to help the person regain control. Do nothing to agitate the situation. The person is probably terrified by the subjective experience of loss of control over thoughts and feelings. The “voices” may be giving life-threatening commands; messages may be coming from light fixtures; the room may be filled with poisonous fumes; snakes may be crawling on the window. Accept the fact that the person is in an “altered reality state” and may “act out” the hallucination. For example, they may shatter the window to destroy the snakes. It is imperative that you remain calm. If you are alone, call someone to stay with you until professional help arrives.

The person may have to be hospitalized. Try to convince him or her to go voluntarily; avoid patronizing or authoritative statements. If necessary, take steps to start the involuntary treatment process. If indicated, call the police but ask them not to brandish any weapons. Explain that your relative or friend has mental illness and that you have called for help.

• Don’t Threaten. This may be interpreted as a power play or prompt assaultive behavior.
• Don’t Shout. If the person isn’t listening, other “voices” are probably interfering.
• Don’t Criticize. It will make matters worse; it can’t make things better.
• Don’t Squabble with Other Family Members over “best strategies” or allocations of blame. It is not the time to prove a point.
• Don’t Bait the person into acting out wild threats; the consequences could be tragic.
• Avoid Continuous Eye Contact or Touching.
• Comply with Requests that are not endangering or beyond reason. This gives the person the opportunity to feel somewhat “in control.”
• Don’t Block the Doorway but keep yourself between the person and an exit.

Emergencies that have happened over the last two years with your mentally ill loved one will probably be the same ones that will happen over the next two years. Review what was done in the past and how it could be improved. Then you will have a plan that can guide your actions in future emergencies.

The Plan

• The plan should be written. Trying to remember details in a crisis can be difficult. Having a written list of steps and procedures can help you focus on the immediate situation.
• Include phone numbers and addresses of resources:
  • Mental health clinic, outpatient facility.
  • Emergency inpatient facilities.
  • Emergency/Crisis teams who have responded in the past.
  • Friends and relatives who will provide support.
• Have solutions to problems that have worked in the past.
  For example, “Call the outpatient clinic and leave a message telling the doctor what has been happening and suggesting that an increase or change in medication may be helpful.”
• Have instructions on what to do and how to act.
  For example “If _______gets upset, stay calm and call the emergency line # __________________.
• Have alternatives for all times: day and night, weekdays and weekends.
  For example, “If the outpatient clinic is closed, call __________________.
• Have alternatives if first steps don’t work.
  For example, If such and such number doesn’t answer, try ______.
• Have the plan carry through to the final resolution of the problem.
  Don’t leave anything to chance.

If the you feel that the patient is IMMEDIATE DANGER to self or others, call 911. Mention that the person is suffering from a mental illness. Police or sheriff deputies will respond.

Contact one or all of the following:

Mental Health Psychiatric Mobile Response Team (PMRT / Pet Team) Psychiatric Mobile Response Team (818) 832-2410 or 2400. Weekdays 8a.m.-5p.m., Other times call (800) 854-7771

S.M.A.R.T. Team* — Monday – Friday (213) 473-8263 *(Systemwide Mental Assessment Response Team)

For Non-Emergency - LAPD - 877-ASK-LAPD (877 275-5273)

MET- Mental Health & Sheriff for County (800) 854-7771

Some of these my have lengthy response times, so REMEMBER, if you or the patient is in immediate danger call 911.

• Hollywood Community of Van Nuys 818-787-1511
• Mission Community Hospital-San Fernando 818-787-2222
• Northridge Hospital-Van Nuys 818-885-8500
• Olive View Medical Center-Sylmar 818-364-3205
• Los Angeles County Health Services
• Henry Mayo-Valencia 888-383-0558
• Pacifica Hospital of the Valley-Sun Valley 818-767-3310
• Tarzana Treatment Center: Drug/Alcohol-818-996-7019

You can take your loved one to Olive View Urgent care from 8 am to 7 pm Monday through Friday, and from 9am-5:30pm on the Saturdays. Sundays they are closed.

Olive View Community Mental Health Urgent Care Center
14659 Olive View Dr Sylmar, CA 818-485-0888

Or these other care centers:

Center for Family Living
Hillview Mental Health Center
Santa Clarita Mental Health Clinic
San Fernando Mental Health Center
Verdugo Mental Health Center
West Valley Mental Health Center
Sherman Oaks Hospital
MacDonald Carey East Valley Mental Health Center

Please be sure to call ahead to check their hours before you leave.

Follow this link, My Family Member Has Been Arrested, to access a to help families cope with the criminal justice system in Los Angeles County when a family member who suffers from a brain disorder (mental illness) is arrested.

Helpful Forms:
English: Inmate Medication Form
Spanish: Inmate Medication Form

(This article originally appeared in NAMI Long Beach Newsletter in May, 1994 and has helped many families and individuals)

Keep an Up-to-date History Summary
Keep a summary of up-to-date information on your mentally ill loved one. This summary can be given to treatment facilities to speed treatment and avoid confusion and mistakes. The summary should be only one or two pages long. List items of significance pertaining to your love one’s illness:

• Past treatments: types of things that have worked well and things that have led to complications.
• Diagnosis—just the most recent. Include a brief statement about when the person became ill and what the person was like before the illness.
• List hospitalizations and reasons.
• Suicide attempts, when and how.
• Acts of violence, when, how and against whom or what.
• Currently under treatment for (diagnosis).
• Current treating psychiatrist (if any) and current medication(s) and dosages and any side effects.
• If not taking any medication, say so
• History of drug and/or alcohol use.
• Physical ailments

If you need someone to talk to anonymously about your mental well being you can call:

Mental Health Crisis Hotline – 800-854-7771
Its ALWAYS OPEN, and can give you guidance with most concerns about your mental health.

SUICIDE HOTLINE: 877-727-4747
The hotline is open 24 hours a day, and a counselor can try to help if you are having thoughts of suicide.

Teens-Teen Line: 310-855-HOPE or TLC-TEEN.
Teens can call the teen line from 6p.m. to 10p.m to discuss their concerns with a counselor.

If you would like to see a doctor you can go to a mental health urgent care:

Olive View Community Mental Health Urgent Care Center
14659 Olive View Dr Sylmar, CA 818-485-0888

Walk-in voluntary care for those in mental health crisis.

8am – 7pm Monday to Friday.

Saturdays 9 am to 5:30 pm

Closed Sundays

Where to go if the patient / your loved one needs psychiatric hospitalization

If you feel like you need hospitalization, you can visit one of these hospitals with psychiatric units:

• Hollywood Community of Van Nuys -818-787-1511
• Mission Community Hospital -San Fernando 818-787-2222
• Northridge Hospital -Van Nuys 818-885-8500
• Olive View Medical Center -Sylmar 818-364-3205
• Los Angeles County Health Services
• Henry Mayo -Valencia 888-383-0558
• Pacifica Hospital of the Valley -Sun Valley 818-767-3310
• Tarzana Treatment Center: Drug/Alcohol -818-996-7019

Predictable Stages Of Emotional Responses To Mental Illness

I. Dealing with the Catastrophic Event

Denial: A protective response giving us time to process the painful events that have turned our lives upside down. We decide all this is not really happening and/or there is a perfectly logical explanation for these events and/or it will pass, etc. We “normalize” what is going on.

Hoping-against-hope: The dawning of recognition and the hope that “this is not what I think it is”—that it is something easier to deal with. Here we assume that if we make a huge effort it will change everything and our lives will go back to normal. This usually does not work; another crisis or relapse dashes our hopes (families call this the “roller-coaster”).

Needs: *Support *Comfort *Empathy for confusion *Help finding resources *Crisis intervention *Prognosis *Empathy for pain *NAMI

II. Learning to Cope: “Going through the Mill”

Recognition: The fact that a catastrophic illness happened to someone we love becomes a reality for us. It is clear something tragic occurred that has changed our lives together. We begin to mark time as before/or/after the event of illness.

Grief: We mourn the loss of the time before illness struck; we deeply feel the tragedy of what has happened to the person who is ill; we grieve that our future together is uncertain. If our loved ones have attacked or rejected us in their illness, we feel inconsolable. Because these illnesses are either episodic or chronic, our grief does not go away: it is “chronic sorrow.”

Needs: *Vent feelings *Keep hope *Education *Self-care *Networking *Skill training *Letting go *Cooperation from system *NAMI

III. Moving Into Advocacy: “Charge!”

Acceptance: Yes, we finally say bad things do happen to good people. We surely wish this trouble had not come into our lives, but it did, and we can accept our misfortune. It is not our fault; it is not their fault. It is a sad and difficult life experience, but we will hang in there and manage.

Advocacy/Action: With a measure of acceptance, we can now focus our anger and grief, and work to confront the system that has often failed us. We are ready to “come out,” to fight discrimination and to change the world that shames the mentally ill and their families. We join public advocacy groups. We get involved.

Needs: *Activism *Restoring balance in life *Responsiveness from system *NAMI

There are some important points to emphasize here:

1. None of these states are “wrong” or “bad.” They are normal reactions everyone experiences when struggling to cope with serious illness and trying to deal with critical disruptions in their lives.
2. This process is ongoing—for most of us it has taken years. The process is also cyclical; we will start it all over again every time our relative has a relapse, or suffers a serious setback.
3. Different family members are often at different places in the cycle, which is why we sometimes have difficulty communicating with each other and agreeing on what to do.
4. This developmental account is not about expectations. This is a human process that you do your way. If you know where you are in it you can be gentler with yourself. We think it offers hope to see that we do progress through pain and grief to acceptance.